Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis

A slipped capital femoral epiphysis occurs when there is a fracture at the neck or top of the thigh bone causing hip pain. It is more common in boys aged 11 to 16 years old and usually develops gradually but can occur suddenly. Failure to recognise this injury may cause long term damage and surgery may be required.

On this page:

  • Symptoms & diagnosis
  • Causes & anatomy
  • Treatment

Symptoms of a slipped capital femoral epiphysis

A slipped capital femoral epiphysis is more likely to affect older children between the ages of 12 and 15 years. Symptoms consist of pain in the hip and groin which can radiate into the knee. Symptoms are likely to have developed gradually over time but can also occur suddenly. The patient is very likely to walk with a limp.

When examined they may find one leg is shorter than the other and may be rotated outwards slightly. The patient will have limited ability to abduct the leg and rotate it inwards when compared with the other leg. So when they attempt to move the leg out to the side it will have a natural tendency to rotate outwards because of the limited mobility.

An X-ray will be done to confirm the diagnosis and will show a thickening of the epiphysis (growth plate).

Causes & anatomy

Slipped capital femoral epiphysis

The epiphysis is the area of the bone that ‘does the growing’ in children and adolescents and is sometimes called the growth plate. A fracture or slipping of the bone occurs at the growth plate.

A slipped capital femoral epiphysis is not a particularly common condition but does typically affects boys aged twelve to fifteen years old. It may be brought on by sports activity. Athletes who are overweight and late maturing are also more prone to suffering the injury because of the additional stresses and strains on the growing bones.

It is very important to consider a slipped capital femoral epiphysis in young athletes because if it is not recognised and treated it can lead to more series, long term problems. In particular, a decrease in blood flow to the head of the Femur will result in the bone dying (avascular necrosis), and so should be addressed as soon as possible.

Treatment of a slipped capital femoral epiphysis

If a slipped capital femoral epiphysis suspected then seek medical attention as soon as possible. An acute, sudden onset injury is a medical emergency requiring immediate surgery. A slipped capital femoral epiphysis which develops gradually may also require surgery. Failure to treat this injury may lead to the death of the head of the femur and permanent injury or disability.

If this injury is suspected X-rays will be taken to confirm the diagnosis and assess how bad it is. If positive, orthopedic assessment is required and surgery may be performed.

Surgery involves fixing the head of the femur with pins or a screw, followed by a period of immobilisation. A full rehabilitation program is required to progress the patient to full weight bearing, and then to regain full strength and movement in the hip.

This article has been written with reference to the bibliography.